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Environmc al Health Department <br />10. <br />OR <br />12. <br />Q One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />Q Paper towels and pump-style soap container. <br />13. <br />••Important** <br />Completed by.14.Titlemature <br />Health Permit <br />Paper Hand Toweit <br />CuangBoerd <br />Prepare Skive <br />Prewan*- I-w* <br />F*eEitt>0u«hM <br />Saemo wtfChaAng <br />Dst> <br />5 Gal Hand Mnh <br />WiMtewKM Contwer <br />MO Gal <br />Hand wMh Water <br />Garbage <br />Can <br />Sanitize' txxket- <br />bleach & wntCT for <br />sieving wptfvj ckxh* <br />isible persons to be present in booth during all hours of operation: <br />■ ________________-______ <br />Booth must be < <br />Concrete. Asphi <br />Plywood, or a Ta <br />operation. Return original to festival coordinator three weeks prior to <br />Cco/ <br />SAN-JOA, JIN <br />COUNTY <br />G'cofnfis grc>y$ hpre <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (if food is used the following day. maintain below 41 °F temperature). <br />05ce chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify)------------------------------------------------------------------------------------------------------------------- <br />I Eteach <br />I ice Cooler M <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. A copy of this checklist must be to the booth at all hours of <br />preparation ai - - -• • ** * « <br />this event <br />Names of responsible p( <br />I Soap dspemer I <br />Food Conearm mat bv ■ <br />aXsst/tncftteoffo/twgrowM* ■ <br />11. lam providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br /> Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth <br /> Water supply dispenser with warm water at a minimum of 100’F (t.e. 5-20 gallon container with spigot). <br />SMpano WM« RtftMWMH | | BtekCh friWatw